Appliance to be implanted, method of collapsing the appliance to be implanted and method of using the appliance to be implanted

ABSTRACT

The artificial blood vessel A comprises a front end wire ring  10   1 , a rear end wire ring  10   2  arranged facing to the front end wire ring  10   1 , a tubular cover  7  which connects the end wire rings  10   1   , 10   2 , and a plurality of intermediate wire rings  12  arranged spaced apart from each other between the front end wire ring  10   1  and the rear end wire ring  10   2 . Each of the front end wire ring  10   1 , the rear end wire ring  10   2  and the intermediate wire rings  12  are given flexibly foldable elasticity. The circumference of the front end wire ring  10   1  is equally divided into four by dividing points  41   1   , 42   1   , 43   1   , 44   1 . Hooking means  13  are formed for a front pull string to be passed through at the dividing points  41   1   , 43   1 . The circumference of the intermediate wire ring  12  is fixed to the tubular cover  7  by suturing or with adhesive at the positions  51   3   , 52   3   , 53   3   , 54   3  which correspond to the midpoint  51   1  between the dividing points  41   1   , 42   1 , the midpoint  51   1  between the dividing points  42   1   , 43   1 , the midpoint  53   1  between the dividing points  43   1   , 44   1 , and the midpoint  54   1  between the dividing points  44   1   , 41   1 .

This is a division of application Ser. No. 08/898,427, filed Jul. 22,1997 which is a division of application Ser. No. 08/765,216, filed Jan.3, 1997 now U.S. Pat. No. 5,843,162, which is a 371 of PCT/JP96/01347filed May 17, 1996.

FIELD OF THE ART

This invention relates to appliances for medical treatment and, moreparticularly, to an appliance collapsible for insertion into a humanorgan and capable of resilient restoration (which will be referred to as“the appliance to be implanted” in this specification and claims), to amethod of collapsing the appliance to be implanted, and to a method ofusing the collapsed appliance to be implanted into a catheter.

BACKGROUND ART

The artificial blood vessel is an example of the appliance to beimplanted. At present, treatment of, for example, aortic aneurysm isconducted by implanting an artificial blood vessel. In particular, theportion of a blood vessel which has an aneurysm is removed by resection,and an artificial blood vessel is implanted in place of the resectedportion and connected to the remaining blood vessel by suturing or thelike.

The above-mentioned method of surgically implanting the artificial bloodvessel for treatment of aortic aneurysm, however, is highly dangerous.Especially, an emergency operation for treatment of a ruptured aneurysmhas a low life-saving rate, and an operation of dissecting aorticaneurysm is difficult to conduct and has a high death rate.

Therefore, in order to treat these diseases without a surgicaloperation, a method has been developed of introducing a catheter into anappliance such as an artificial blood vessel in collapsed condition intoa human organ such as a blood vessel, and transporting the appliance toa desired position such as an affected or constricted portion thereof,where the appliance is released so as to be expanded and implantedthere.

The appliance to be implanted is so constructed that a pair of end wirerings which are flexibly foldable and elastic are arranged to dividethemselves, each of the end wire rings is connected by a tubular coverwhich is made of a sheet of flexible and tensile material and anintermediate wire ring is arranged between both of the end wire ringsand fixedly connected to the above-mentioned tubular cover by suturingor with adhesive.

As a method of collapsing the appliance to be implanted, the followingmethod is adopted in which a plurality of hooking means for a pullstring to be passed are formed at every other dividing points each ofwhich equally divides the circumference of the front end wire ring intoan even number, the front end wire ring is folded into a wavy shape withthe dividing points which are provided with a hooking means for a pullstring forming forwardly directed peaks and the dividing points whichare not provided with a hooking means for a pull string forming thebottoms of forwardly directed valleys, each of the intermediate wirerings and the rear end wire ring is folded into a wavy shape having thesame phase as that of the front end wire ring and the whole artificialblood vessel is inserted into a catheter.

The above-mentioned intermediate wire ring is inevitable because ofseveral points of view, such as it provides the artificial blood vesselwith a capability of keeping its tubular shape so as to fit a human bodywhen arranged at a bent position in a body, thereby to prevent theartificial blood vessel from being pushed downstream. However, if suchan intermediate wire ring is attached to the tubular cover, theappliance is easily prevented from being folded. The reason is that thetubular cover tries to follow the movement of the front end wire ringwith forming big wrinkles near the front end wire ring when the frontend wire ring is folded into a wavy shape since the tubular cover isconnected to the front and rear end wire rings at both end portionsthereof. However, as the tubular cover is made of a sheet, the locallyformed wrinkles do not bring about transformations at the center of thetubular cover. Therefore, for example, if the whole area of thecircumference of the intermediate wire ring is fixedly connected to thetubular cover, the center of the tubular cover is dragged at thespecified positions of the circumference thereof toward the direction ofthe peak or the valley along the wavy shape of the intermediate wirering and the whole tubular cover tends to be bulky as well asunfavorable load is applied to the intermediate wire ring because of thesliding resistance. Therefore, the intermediate wire ring may behindered from being folded into a small size with forming a regular wavyform because of distortion of the direction the intermediate wire ringis to be folded as well as of folding force. Even though theintermediate wire ring is fixedly connected to the tubular cover only atseveral points of the circumference thereof each of which is spacedapart, the points selected at random will cause sliding resistance fromthe tubular cover toward the peaks or valleys, thereby to provide noeffective means to solve the problems.

In addition, the mutual interference between the intermediate wire ringand the tubular cover not only prevents the intermediate wire ring frombeing folded but also folds the appliance to be implanted imperfectlyand insufficiently. Bent portion caused by the appliance to be implantedunnaturally folded will cut off the permanent function as a bloodvessel. This also may hinder the movement of transporting the artificialblood vessel through a catheter and the function of the appliance to beimplanted as it is intended to because of imperfect restoration of theappliance to be implanted even though the appliance to be implanted isreleased at a target portion.

On the other hand, the blood vessel is distributed variously in a bodyand, for example, an artery which comes from a heart is bifurcated atthe groin of a thigh. If an affected part falls on the bifurcated part,the above mentioned cylindrical-shaped artificial blood vessel can notbe used as it is, so that it is inevitable that an artificial bloodvessel whose shape fits for such a shape of blood vessel should bedeveloped. In addition, for implanting an artificial blood vessel insuch a bifurcated part it is not enough just to transport the artificialblood vessel to a target position through a catheter and release itthere. In this case, it is necessary to move the artificial blood vesselto be fit for a shape of the blood vessel at an target position afterreleased, thereby requiring to develop a method of moving the artificialblood vessel.

The object of the invention is to solve all of the above-mentionedproblems.

DISCLOSURE OF THE INVENTION

The appliance to be implanted in accordance with the invention ischaracterized by that comprising a front end wire ring, a rear end wirering arranged facing to the front end wire ring, a tubular cover whichconnects the front end wire ring and the rear end wire ring, and aplurality of intermediate wire rings spaced apart from each otherbetween the front end wire ring and the rear end wire ring, that each ofthe front end wire ring and the rear end wire ring and the intermediatewire rings are given flexibly foldable elasticity, that thecircumference of the front end wire ring is equally divided into four oran even number over four, hooking means are formed for a front pullstring to be passed through at every other dividing point and that thecircumference of the intermediate wire ring is fixed to the tubularcover by suturing or with adhesive at the positions which correspond tothe midpoints between each adjacent two of the dividing points of thefront end wire ring.

The appliance to be implanted may concretely be represented by that asingle rear end wire ring is arranged to face to a single front end wirering, or that parallely arranged two rear end wire rings are arranged toface to a single front end wire ring and a bifurcated tubular coverconnects the front end wire ring and two rear end wire rings withforming a Y-shape.

To improve the implanting state of the appliance to be implanted, it iseffective that each of the front and rear end wire rings iscircumferentially covered with an elastic protective material, thornsare provided on the circumference of at least one of the wire rings soas to stick into a human organ to be embedded therein, or a pole isprovided to connect at least two adjacent wire rings.

The method of collapsing the appliance to be implanted in accordancewith the invention is characterized by that the appliance to beimplanted comprises a front end wire ring, a rear end wire ring arrangedfacing to the front end wire ring, a tubular cover which connects thefront end wire ring and the rear end wire ring, and a plurality ofintermediate wire rings spaced apart from each other between the frontend wire ring and the rear end wire ring, that each of the front andrear end wire rings and the intermediate wire rings are given flexiblyfoldable elasticity, that the circumference of the front end wire ringis equally divided into four or an even number over four, hooking meansare formed for a front pull string to be passed through at every otherdividing point and that the circumference of the intermediate wire ringis fixed to the tubular cover by suturing or with adhesive at thepositions which correspond to the midpoints between each adjacent two ofthe dividing points of the front end wire ring, and that the methodcomprises the steps of; folding the front end wire ring into a wavyshape with the dividing points each of which is provided with a hookingmeans forming forwardly directed peaks and the other dividing pointsforming the bottoms of forwardly directed valleys, and folding theintermediate wire rings and the rear end wire ring each into a way shapehaving the same phase as that of the front end wire ring, thereby toinsert the whole appliance to be implanted into a catheter.

If the number of the dividing points are four, it is effective to pickthe whole appliance to be implanted by forceps along a generatrix whichpasses two points facing each other on the front end wire ring and eachof which is provided with a hooking means and then to insert theappliance to be implanted together with the forceps into the funneledtube from a big portion of the funneled tube toward a small portionthereof, and finally to pull the forceps out of the funneled tube.

The forceps may preferably be provided with serrate engaging memberwhich lessens a sliding resistance between the appliance to be implantedand the forceps toward the direction to be pulled than that to beinserted.

For inserting an appliance to be implanted which has been kept in acollapsed condition into a catheter, it is effective that a pair ofstrings each of which has a loop at the tip thereof are provided foreach of the wire rings respectively, that the strings are engaged witheither one of the wire ring or the tubular cover at the positions of thecircumference of each wire rings which correspond to the midpointsbetween two adjacent dividing points of the front end wire ring, and oneof the strings is wound around the wire ring clockwise until it reachesthe backward of the wire ring while the other string is wound around thewire ring counterclockwise until it reaches the backward of the wirering, that a retaining rod is passed through the part at which each ofthe loops overlaps, and that each of the strings is tied each other soas to keep each of the wire rings in a collapsed condition. Theretaining rod may preferably comprise a tube and a wire which isinserted into and passed through the tube. It is especially advantageousthat after the wire rings are kept in a collapsed condition, the tube ispulled out so as to keep the collapsed condition by the wire alone.

For collapsing each wire rings into a wavy shape by inserting theappliance to be implanted into a funneled tube from a big portion of thefunneled tube toward a small portion thereof, it is effective theappliance has previously been contained in a pipe member having adiameter which is bigger than that of the small portion of the funneledtube and smaller than that of the big portion of the funneled tube.

The method of using the appliance to be implanted in accordance with theinvention is characterized by that the appliance to be implantedcomprises a single front end wire ring, parallely arranged two rear endwire rings facing to the front end wire ring, and a Y-shaped tubularcover connecting the front end wire ring and the rear end wire rings, inorder to implant the appliance to be implanted into a Y-shaped portionhaving two branches bifurcated from a single trunk a front hooking meansis formed at the front end wire ring for pulling whole of the applianceto be implanted forward and a rear hooking means is formed at each ofthe rear end wire rings for pulling the appliance to be implantedrearward respectively, and that the method comprises the steps of;pulling the front hooking means of the front end wire ring toward thetarget portion to be implanted so as to transport the appliance to beimplanted through one of the branches to the trunk, and then pullingeach of two rear hooking means of the rear end wire rings so as to drageach of the rear end wire rings to one of the branches and to the otherbranch respectively.

For inserting one of the rear hooking means of the appliance to beimplanted into one of the branches of a Y-shaped portion to be implantedand dragging it into other branch thereof, it is effective that a devicefor transporting an appliance to be implanted is attached to the rearhooking means of the appliance to be implanted so as to urge theappliance to be implanted rearward when the appliance to be implanted istransported to near the trunk through one of the branches and that thedevice for transporting an appliance which is attached to one of therear hooking means of the appliance to be implanted is caught anddragged into other branch by a catcher which has been inserted into nearthe trunk through other branch.

For securely catching the device for transporting an appliance by acatcher, it is preferable that the device for transporting an applianceto be implanted which is to be dragged out of the body by a catcher istransported to a portion to be implanted through one of the brancheswith the front end of the device engaged with the rear hooking means,that the base end of the device is turned down and transported to theportion to be implanted through the same branch, and then the base endof the device is caught by the catcher.

For effectively preventing the device for transporting an appliance tobe implanted from entangling in the appliance to be implanted, it ispreferable to adopt a method that comprises steps of ; arranging a guidepipe which has a valve at the base end thereof along one of the branchesand into which the front end of the device for transporting an appliancehas previously been inserted through a hole provided on the valve bybeing pushed to open the hole with making use of the elasticity of thehole, pushing the base end of the device for transporting an appliancewhich is turned down so as to be inserted into the guide pipe throughother hole provided on the valve so as to open the hole with resistingthe elasticity of the hole, and pulling the catcher which catches thebase end of the device for transporting an appliance so that the twoholes become continuous each other and the turned down portion of thedevice for transporting an appliance is contained in the guide pipe.

For making it easy to transport the appliance to be implanted it ispreferable that a pair of strings each of which has a loop at the tipthereof are provided for each of the wire rings respectively, that thestrings are engaged with the tubular cover at the positions of thecircumference of each wire rings which correspond to the midpointsbetween two adjacent dividing points of the front end wire ring, and oneof the strings is wound around the wire ring clockwise until it reachesthe backward of the wire ring while the other string is wound around thewire ring counterclockwise until it reaches the backward of the wirering, that a retaining rod is passed through the part at which each ofthe loops overlaps, and that each of the strings is tied each other soas to keep each of the wire rings in a collapsed condition.

For making use of the appliance to be implanted more generally eventhough the shape of the portion into which the appliance to be implantedis implanted varies it is effective to adopt a method of using theappliance to be implanted that at least two appliances to be implantedare prepared, that the front end wire ring of the appliance to beimplanted which is inserted later locates in front of the rear end wirering of the other appliances to be implanted which is inserted former,and that the appliance is connected to the adjacent appliance with eachother partially overlapped at the adjacent position. In this case, it isespecially preferable that the appliance to be implanted arrangeddownstream has a diameter which is smaller than that of the appliance tobe implanted arranged upstream and the appliance to be implanteddownstream is partially inserted into the appliance to be implantedupstream.

With the appliance to be implanted and the method of collapsing theappliance to be implanted in accordance with the invention, theoperation of collapsing the appliance to be implanted can be conductedsmoothly and the condition of which the appliance is implanted becomessatisfactory. In other wards, as the intermediate wire ring is collapsedinto a wavy shape having the same phase as that of the front end wirering, to put it in an extreme way each of the points on thecircumference corresponding to the dividing points forms a peak of amountain or a bottom of a valley formed between two mountains by takingturns while the positions corresponding to midpoints between eachadjacent two of the dividing points move neither frontward nor rearwardat all. As the intermediate wire rings are fixedly attached to thetubular cover at several points each spaced apart, the portions of theintermediate wire ring which bent most when being folded are free of thetubular cover. This makes the intermediate wire ring free from draggingresistance from the tubular cover, thereby to secure the free movementto be collapsed with ease. In addition, as the intermediate wire ring iscollapsed into a wavy shape as well as the front end wire ring, thewhole appliance is given a big folding rate, thereby to secure a compactcollapsed state and good transporting movement through a catheter for arelatively bulky appliance to be implanted. In addition, in accordancewith the arrangement, if the appliance to be implanted is released at atarget position in a blood vessel, the dividing points are restoredtoward right-angled direction to the blood vessel, and the end portionof the appliance to be implanted certainly open and does not close theinner space thereof. This helps the appliance to be implanted toappropriately follow the movement of the constantly pulsating bloodvessel with close adherence as well as improves a rate of successfulimplantation. The above-mentioned operation functions for not only asimple tubular shaped appliance to be implanted but also a bifurcatedY-shaped appliance to be implanted.

Elastic protective material circumferentially covering the wire rings ofthe appliance to be implanted is useful to prevent the inner wall of ahuman organ from being damaged by direct contact with the wire rings.The protective material also acts as a seal to attach both ends of theappliance to be implanted tightly to the inner wall of a human body,thereby to effectively prevent leakage of blood through the ends of theappliance when implanted.

When thorns are provided projecting from the wire rings, they stick intothe inner wall of a human organ to be embedded therein so that the wholeappliance is fixed to the human organ. Therefore, the thorns effectivelyprevent the appliance to be implanted from being displaced or evencarried by blood flow downstream in a blood vessel.

It can effectively improve the tubular shape of the whole appliance tobe implanted in the strength and the construction if at least two of theadjacent wire rings are connected by a rod.

If the number of the dividing points is four, it is extremely easy tofold the appliance to be implanted by using a pair of forceps. Namely,if the appliance to be implanted is inserted into the funneled tube withthe whole appliance picked by forceps along a generatrix which passestwo points facing each other on the front end wire ring each of which isprovided with a hooking means, the points picked by the forceps arecarried in advance from the big portion to the small portion of thefunneled tube while other points approach each other with restrained bya tapered surface of the inner wall of the funneled tube from movingforward following the points having a hooking means. The points pickedby the forceps inevitably form a peak of a mountain and the midpointsbetween two adjacent points picked by the forceps form a bottom of avalley, thereby to fold the appliance to be implanted into anappropriate wavy shape. In this case, the intermediate wire rings areeasily transformed to the direction so as to form a mountain and avalley with the points on the circumference of the intermediate wirering corresponding to the midpoints between two adjacent dividing pointson the front end wire ring serving as fulcrum, which makes the operationof folding the appliance smooth and appropriate.

In this case, if the forceps are provided with serrate engaging member,the pushing force applied to the forceps can effectively be transformedto a force of propelling the appliance to be implanted by making use ofthe serrations of the engaging member when inserting the appliance to beimplanted, and the forceps can be smoothly withdrawn from the funneledtube without dragging the appliance to be implanted by making use of theserrations of the engaging member.

If the points on the circumference of the intermediate wire ringcorresponding to the midpoints between two adjacent dividing points aretied by a pair of strings each of which has a loop at the tip thereofand a retaining rod is passed through the part at which each of theloops overlaps, the appliance to be implanted is kept in a collapsedcondition. This makes it possible that the appliance to be implanted isinserted into a catheter without using a funneled tube. This also makesit easy to adjust the position at which the appliance is implantedbecause the appliance to be implanted can be kept in a collapsedcondition after it is released from the catheter. This method is usefulespecially for the appliance to be implanted whose shape is bifurcated.In addition, if the retaining rod is pulled out, the loops overlappingeach other are released from binding and free to move. As the portion atwhich the stings are sewed to the tubular cover is loosened, the forceto keep the appliance to be implanted in a collapsed condition isreleased, and then the appliance to be implanted is restored to theoriginal shape without bound by strings. In this case, as the stringsare used as not a single but a pair, even though one of the stringsmight get stuck on the way, the appliance to be implanted is guaranteedto restore by another string.

If the retaining rod comprising a tube and a wire is used and the tubeis pulled out with the wire left in a collapsed condition, the wholeappliance to be implanted remains flexible with the wire functioning asthe retaining rod. This makes it possible that the appliance to beimplanted passes smoothly through the bent portion or the like whentransported in a collapsed condition.

If the appliance to be implanted has previously been contained in a pipemember having a diameter bigger than that of the small portion of thefunneled tube and smaller than that of the big portion of the funneledtube, it saves the operation of collapsing the appliance to beimplanted. Just inserting the pipe member into the funneled tube so asto make abutting engagement with the inner surface of the funneled tubeand pulling out the appliance to be implanted from the side of the frontend wire ring enables the appliance to be implanted to be collapsed intoa smaller size so as to be inserted into the small portion of thefunneled tube and a catheter.

With the method of using the appliance to be implanted in accordancewith the invention, a Y-shaped appliance to be implanted can effectivelybe transported to be implanted into a portion at which a blood vesselbranches out into two, thereby to greatly improve the appliance to beimplanted in use generally and practically.

In this case, if a catcher is inserted into near the portion to beimplanted and catches a device for transporting the appliance which isattached to one of the rear end wire rings of the appliance to beimplanted, it can be extremely easy to fix the appliance to be implantedinto a bifurcated portion to be implanted.

If the front end of the device for transporting the appliance is engagedwith the appliance to be implanted and the base end of the device fortransporting the appliance is turned down so as to be caught by thecatcher, it becomes easy to arrange the device for transporting theappliance at a position where it is easy for the catcher to catch. As aresult of this, the accuracy and the efficiency of implanting theappliance to be implanted is effectively improved.

During the above process if a guide pipe having a valve is used, itbecomes possible to guide the base end of the device for transportingthe appliance to a position preferable to be caught with not onlypreventing bleeding but also preventing the device for transporting theappliance from entangling in the appliance to be implanted.

If a pair of the appliances to be implanted in accordance with theinvention are connected to partially overlap, it can change the lengthof the connected appliances relatively freely by adjusting the length ofthe overlapped portion. This makes it possible to commonly use the samestandardized appliances to be implanted for the organ into which theappliance is to be implanted even though the length or the shape of theorgan varies a little. If the appliance to be implanted arrangeddownstream is partially inserted into the appliance to be implantedarranged upstream, not only both of the appliances to be implanted canbe connected smoothly but also the appliance can be implantedsatisfactory so as to fit the shape of the blood vessel into which theappliance is to be implanted because usually blood vessels are graduallysmaller in diameter from upstream to downstream.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of an artificial blood vessel used in oneembodiment of the invention. FIG. 2 is a vertical cross-sectional viewof part of the artificial blood vessel. FIG. 3 is an enlargedperspective view of part of the intermediate wire ring constituting theartificial blood vessel. FIG. 4 shows a condition how the intermediatewire ring is fixed to the tubular cover. FIG. 5 is a perspective view ofa device for transporting the artificial blood vessel, used in theembodiment. FIG. 6 is a perspective view of a device for introducing theartificial blood vessel, used in the embodiment. FIG. 7 is a perspectiveview of a cartridge constituting the device for introducing theartificial blood vessel. FIG. 8 is an enlarged vertical cross-sectionalview of part of the attachment shown in FIG. 6. FIG. 9 is an enlargedvertical cross-sectional view of part of the cartridge shown in FIG. 6.FIG. 10 is a side view showing a funneled tube, used in the embodiment.FIG. 11 is a side view showing forceps, used in the embodiment. FIG. 12is a perspective view of the artificial blood vessel through which thedevice for transporting the artificial blood vessel is loosely inserted.FIG. 13 is a perspective view showing a step to hold the artificialblood vessel by means of the device for transporting the artificialblood vessel. FIG. 14 is a perspective view showing a step to hold theartificial blood vessel by means of the device for transporting theartificial blood vessel. FIG. 15 is an enlarged perspective view showingpart of the artificial blood vessel kept by the device for transportingthe artificial blood vessel. FIG. 16 is a perspective view showing astep to introduce the artificial blood vessel into a catheter. FIG. 17is a perspective view showing a step to introduce the artificial bloodvessel into the catheter. FIG. 18 is a perspective view showing a stepto introduce the artificial blood vessel into the catheter by means ofthe forceps. FIG. 19 shows the front end wire ring of the artificialblood vessel being folded. FIG. 20 shows the front end wire ring of theartificial blood vessel being folded. FIG. 21 shows the front end wirering of the artificial blood vessel being folded. FIG. 22 shows thefront end wire ring of the artificial blood vessel being folded in afunneled tube. FIG. 23 is a perspective view showing the intermediatewire rings of the artificial blood vessel being folded. FIG. 24 is anexpanded view showing the intermediate wire rings of the artificialblood vessel being folded. FIG. 25 is a partly cut-out side view showingthe artificial blood vessel inserted into the cartridge. FIG. 26 is adiagram showing each of the wire rings being folded. FIG. 27 is a partlycut-out side view showing the cartridge from which the funneled tube isdrawn out. FIG. 28 is a partly cut-out side view showing the cartridgeconnected to the attachment. FIG. 29 is a cross-sectional view showingthe artificial blood vessel transported to the affected portion. FIG. 30shows a step to release the artificial blood vessel at an affected partin a blood vessel. FIG. 31 shows a step to release the artificial bloodvessel at the affected part in the blood vessel. FIG. 32 is across-sectional view showing the artificial blood vessel released at theaffected portion in the blood vessel. FIG. 33 shows a step to expand theartificial blood vessel by means of a balloon catheter. FIG. 34 is aperspective view of the artificial blood vessel use in anotherembodiment of the invention. FIG. 35 is a perspective view showing theartificial blood vessel which has previously been folded by means of astring. FIG. 36 is a perspective view showing a procedure of folding theartificial blood vessel by means of a string. FIG. 37 is a perspectiveview showing the artificial blood vessel around which a string is wound.FIG. 38 is a perspective view showing a device for transporting theartificial blood vessel. FIG. 39 is a perspective view showing a devicefor transporting the artificial blood vessel to pull the rear end wirering of the artificial blood vessel shown in FIG. 38. FIG. 40 shows theprinciple how the artificial blood vessel of the embodiment is used.FIG. 41 shows the principle how the artificial blood vessel of theembodiment is used. FIG. 42 shows the principle how the artificial bloodvessel of the embodiment is used. FIG. 43 shows the principle how theartificial blood vessel of the embodiment is used. FIG. 44 is a diagramshowing an artificial blood vessel in accordance with a differentembodiment of the invention. FIG. 45 is a diagram showing an artificialblood vessel in accordance with a further different embodiment of theinvention. FIG. 46 is a perspective view showing a device fortransporting the artificial blood vessel in accordance with a furtherdifferent embodiment of the invention. FIG. 47 shows a method ofcollapsing the artificial blood vessel in accordance with furtherdifferent embodiment of the invention. FIG. 48 shows a method of usingthe artificial blood vessel in accordance with further differentembodiment of the invention. FIG. 49 is a view showing a condition of amethod of using in accordance with further different embodiment of theinvention. FIG. 50 is a view showing a condition just before the methodof using has been finished. FIG. 51 is a view showing a valve used for asheath of the embodiment. FIG. 52 is a view showing other valve whichcan be utilized instead of the valve shown in FIG. 51. FIG. 53 is a viewshowing a valve used for a guide pipe of the embodiment. FIG. 54 is aview showing a modification of the device for transporting an artificialblood vessel. FIG. 55 is a cross-sectional view taken along the line55—55 of FIG. 54. FIG. 56 is a cross-sectional view taken along the line56—56 of FIG. 54. FIG. 57 is a cross-sectional view taken along the line57—57 of FIG. 54. FIG. 58 is a view of the device for transporting theartificial blood vessel shown in FIG. 55 viewed from a different angle.FIG. 59 is a view showing a modification of the device for transportingthe artificial blood vessel. FIG. 60 is a cross-sectional view takenalong the line 60—60 of FIG. 59. FIG. 61 is a cross-sectional view takenalong the line 61—61 of FIG. 59. FIG. 62 is a cross-sectional view takenalong the line 62—62 of FIG. 59. FIG. 63 is a view of the device fortransporting an artificial blood vessel shown in FIG. 59 viewed from adifferent angle. FIG. 64 is a cross-sectional view showing amodification corresponding to FIG. 62. FIG. 65 is a view showing amodification different from the above of the device for transporting theartificial blood vessel. FIG. 66 is a cross-sectional view taken alongthe line 66—66 of FIG. 65. FIG. 67 is a cross-sectional view taken alongthe line 67—67 of FIG. 65. FIG. 68 is a view showing a modificationdifferent from the above of the device for transporting the artificialblood vessel. FIG. 69 is a cross-sectional view taken along the line69—69 of FIG. 68. FIG. 70 is a cross-sectional view taken along the line70—70 of FIG. 68. FIG. 71 is a view showing a modification of anartificial blood vessel.

BEST MODES OF EMBODYING THE INVENTION

The invention will be described in detail with reference to theembodiments thereof shown in the accompanying drawings.

The artificial blood vessel A as the appliance to be implanted, which iscollapsed by the method in accordance with this invention, comprises, asshown in FIG. 1, a cover 7, end wire rings 10 ₁, 10 ₂ and intermediatewire rings 12.

The cover 7, as shown in FIG. 2, consists of a flexible, tensile sheetshaped into a tube of bellows, the normal diameter of which generallycorresponds to the shape of that portion of the human blood vessel atwhich the artificial blood vessel A is to be implanted. The sheet of thecover 7 is, for example, of warps extending in the axial direction ofthe artificial blood vessel A woven with wefts extending in thecircumferential direction thereof, wherein the warps are ofmono-filament made of polyester (about 15 denier) and the wefts are ofmulti-filament made of a plurality of superfine filaments (about 50denier) interwoven. The wefts are additionally woven with thread ofpolyethylene of about 10 denier to make the sheet of the cover 7 thinnerand stronger. The cover 7 is coated, if necessary, with waterproofmaterial, for example, collagen or albumin, to prevent leakage of blood.

The front and rear end wire rings 10 ₁, 10 ₂, whose inner diametergenerally corresponds to that of the above-mentioned cover 7, areaxially spaced apart and arranged face to face, and are fixed to theopposite ends of the cover 7 by suturing or with adhesive as shown inFIG. 2. As shown in FIG. 1, loop-shaped front hooking means 13 areformed at a pair of dividing points 41 ₁ and 43 ₁ facing each otheracross the axis of four dividing points 41 ₁, 42 ₁, 43 ₁, 44 ₁ each ofwhich equally quadrisects the circumference of the front end wire ring10 ₁. The hooking means 13 in accordance with the embodiment are formedof string. It may not necessarily be of string, but a hole directlyformed on the cover 7 may be utilized as the hooking means, if there isno trouble. The circumferences of the front and rear end wire rings 10₁, 10 ₂ are covered with protective braid members 10 a, as shown inFIGS. 1 and 2, which are closely fixed to the end wire rings 10 ₁, 10 ₂at appropriate positions with thread, adhesive or the like. Theprotective braid members 10 a are made of, for example, polyester fibertied up in a bundle like cotton. For especially small in diameter bloodvessels into which the artificial blood vessel A is to be implanted theprotective braid members 10 a are preferably attached to the positionsdisplaced ahead to the end wire rings 10 ₁, 10 ₂. This is because theprotective braid members 10 a can be pushed to move to appropriatepositions at which adjacent the end wire rings 10 ₁, 10 ₂ is covered asshown imaginary lines in FIG. 2 when transporting resistance is appliedto.

A plurality of intermediate wire rings 12, each of which comprises, asshown in FIGS. 1 through 4, wire rings 12 a wrapped with protective film12 b made of cloth or the like, are arranged axially andgeneral-equidistantly spaced between the front and rear end wire rings10 ₁ and 10 ₂, and fixed to the cover 7 at specified positions on thecircumference thereof with thread, adhesive or the like. The specifiedpositions are the points 513, 523, 533, and 543 on the circumferenceeach of which corresponds to the midpoint 51 ₁ between the dividingpoints 41 ₁, 42 ₁ of the end wire ring 10 ₁, the midpoint 52 ₁ betweenthe dividing points 42 ₁, 43 ₁, the midpoint 53 ₁ between the dividingpoints 43 ₁, 44 ₁ and the midpoint 54 ₁ between the dividing points 44₁, 45 ₁ respectively, more specifically, the points at which each of thegeneratrices l₁, l₂, l₃, and l₄ passing through the midpoints 51 ₁, 52₁, 53 ₁, and 54 ₁ of the end wire rings 10 ₁ crosses the intermediatewire rings 12. The above-mentioned front and rear end wire rings 10 ₁,10 ₂ and the intermediate wire rings 12 help keep the tubular shape ofthe cover 7.

Some of the intermediate wire rings 12 are provided with thorns 12 a ₁which are formed at two diametrically opposite positions on each of thecircumference thereof and which stick into a human organ so as to beembedded therein. In particular, the wires 12 a of the intermediaterings 12 as well as those of the front and rear end wire rings 10 ₁, 10₂ are made of Ti-Ni alloy or the like. The wires of Ti-Ni alloy have ahigh resilient restoring force, but are hard to weld. Then as shown inFIG. 3, a partially cylindrical shaped fixing member 12 c into which theintermediate wire ring 12 is loosely inserted and a thorn 12 a ₁preformed into U-shape or V-shape are prepared. Then the thorn 12 a ₁ ispassed through and inserted into the gap between the intermediate wirering 12 and the fixing member 12 c. And finally the fixing member 12 cis riveted and bound with a string or the like so as to fix the thorn 12a ₁ to the intermediate wire ring 12. The positions at which each of thethorns 12 a ₁ is provided correspond to the above-mentioned positions 51₃, 52 ₃, 53 ₃ and 54 ₃.

In order to implant the artificial blood vessel A of the above-mentionedconstruction into a target organ of a human body, a device B fortransporting the artificial blood vessel (see FIG. 5) is used totransport the artificial blood vessel A to the target organ of the humanbody through the catheter 8 and a device C for introducing theartificial blood vessel (see FIG. 6) is used to introduce the artificialblood vessel A into the catheter 8.

The device B for transporting the artificial blood vessel, as shown inFIG. 5, comprises a flexible metallic tube 2 whose front end portion isconnected to a helical spring 2 a for guiding, a side window 1 formedadjacent the front end of the tube 2, a pair of strings 4 having boththeir ends fixed to the tube 2 adjacent the side window 1 and theirmiddle portions formed into loops to be looped portions 4 a, and alength of wire 3 slidably inserted into the tube 2. Instead of theabove-mentioned helical spring 2 a for guiding, a flexible tube may beused. The device for transporting the artificial blood vessel maycomprise only the tube 2 and a length of wire 3, which will be describedlater.

The device C for introducing the artificial blood vessel, as shown inFIG. 6, comprises an attachment 5 integrally connected to the catheter 8through an open end 8 a thereof, and a cartridge 6 removably attached tothe attachment 5. As shown in FIGS. 6 and 8, the attachment 5 comprisesa first and a second annular member 51, 52 which are internally threadedto form female screws, and a third annular member 53 which is externallythreaded to form male screws at opposite ends, which engages theabove-mentioned female screws thereby to connect the internal space ofthe first and the second annular members 51, 52 at its male screw part.The catheter 8 is formed to have an open end 8 a of a little largerdiameter and attached to the tip of the male screw of theabove-mentioned third annular member 53 at its open end 8 a. Then thethird annular member 53 is liquidtightly joins the interior of the openend 8 a of the catheter 8. Inside the second annular member 52 providedis a check valve 55 made of elastic membrane to close the open endthereof and outside of it fittingly provided is a cylinder-shapedhelical member 52 a having a helical groove. The cartridge 6, as shownin FIGS. 6, 7 and 9, comprises first and second annular members 61, 62which are internally threaded to provide internal female screws, a thirdannular member 63 which is externally threaded to form male screws atopposite ends, which engage the above-mentioned female screws atopposite ends to connect the first and second annular members 61, 62, astraw member 64 whose rear end is liquidtightly attached to the tip ofone of the male screw parts of the third annular member 63 and the frontend of which is extending toward the direction to which the cartridge 6is inserted, a cylinder-shaped guide pipe 65 having an internal diameterwhich can contain the straw member 64, one of whose ends integrallyconnected to the first annular member 61 and the other end thereofprovided with a big portion 65 a, and a cap 66 which is slidably movablealong the axial direction of the guide pipe 65 and loosely fit to theexternal of the guide pipe 65 and inside of which formed is a helicalgroove which helically connects the helical member 52 a of theattachment 5. A check valve 68 made of elastic membrane is providedinside the second annular member 62 to close the open end thereof.

As shown in FIG. 6, the straw member 64 of the cartridge 6 is soconstructed that the front end portion 6 a thereof is removably fittedinto the rear end portion 5 a of the attachment 5. In particular, asshown in FIGS. 6, 8, and 9, the bore diameter d₁ adjacent the open end 8a of the catheter 8 is set generally the same as or a little larger thanthe bore diameter d₂ of the straw member 64 of the cartridge 6, and thelength L₂ of the straw member 64 extending from the big portion 65 a ofthe guide pipe 65 is set approximately equal to the length L₁ betweenthe end portion 5 a of the attachment 5 and the position a little deepfrom the open end 8 a of the catheter 8. The big portion 65 a formed onone end of the cartridge 6 is made abutting engagement with the endportion 5 a of the attachment 5 with the cap 66 helically mounted to theouter surface of the cylinder-shaped helical member 52 a as shown inFIG. 28, and the front end portion 6 a of the straw member 64 isinserted into the open end 8 a of the catheter 8 so that the strawmember 64 is smoothly connected to inside of the open end 8 a of thecatheter 8. The above-mentioned check valves 55, 68 are made of elasticmembrane, in each of which a normally closed hole, not shown indrawings, is formed.

A funneled tube 18 as a guide tube and forceps 19, as shown in FIGS. 10and 11, are provided to help collapse the artificial blood vessel A. Thefunneled tube 18 is provided with an enlarged inlet opening 18 a of anenlarged diameter at the rear end portion, through which the tubularartificial blood vessel A is inserted into the funneled tube 18. Thefunneled tube 18 is gradually reduced in diameter from the enlargedinlet opening 18 a to end in a tubular connector 18 b of a smallerdiameter at the front end portion thereof, so that the tube 18 has atapered inner surface 18 d. The funneled tube 18 is, as shown in FIG.25, removably connected to the cartridge 6 by inserting the frontconnector 18 b into the rear end portion 6 b of the cartridge 6. Theforceps Y9 are used for picking the artificial blood vessel A so as toinsert it into the funneled tube 18. The forceps 19 are provided on itspicking surface with an engaging member 19 a having serrations againstthe direction to be inserted and for the direction to be pulled out soas to lessen the sliding resistance between the forceps 19 and theartificial blood vessel A when the forceps 19 are inserted relativelysmaller than that when pulled out.

The process of collapsing the artificial blood vessel A and implantingit into a position to be implanted, namely, a target portion (anaffected part 26 in FIG. 29) of a blood vessel 9 by means of the deviceB for transporting the artificial blood vessel and the device C forintroducing the artificial blood vessel of the above-mentionedconstructions, will now be described below.

First, the tube 2 of the device B for transporting the artificial bloodvessel is inserted through the artificial blood vessel A as shown inFIG. 12, and each of a pair of strings 4 is passed through each hookingmeans 13 of the artificial blood vessel A as shown in FIG. 13, and thelooped portions of the strings 4 overlap as shown at 4 a. Next, a wire 3has its forward end taken out of the side window 1 as shown in FIG. 14,and the overlapped portions of the looped portions 4 a are hooked overthe wire 3, and then the wire 3 has its forward end inserted again intothe tube 2 through the side window 1 so as to hold the artificial bloodvessel A on the wire 3 and the tube 2 through the strings 4 as shown inFIG. 15. Then, the artificial blood vessel A is inserted into thecartridge 6 shown in FIG. 6 through the funneled tube 18 and with theforceps 19. In particular, the forceps 19 are put along the generatriceseach of which passes through the dividing points 41 ₁ and 43 ₁ with acommon front pull string 20 being passed through the front hooking means13 provided at the dividing points 41 ₁, 43 ₁ on the front end wire ring10 ₁ of the artificial blood vessel A as shown in FIG. 16. Prior to thisoperation a balloon catheter 23, as shown in FIG. 17, may be attached tothe tube 2, if necessary. The balloon catheter 23 comprises a pipe 23 a,a balloon 23 b formed on the front end portion of the pipe 23 a, and anopening 23 c provided in the rear end of the pipe 23 a for air to beintroduced into or taken out of the above-mentioned balloon 23 b throughthe pipe 23 a. The pipe 23 a is loosely fitted over the tube 2 of theabove-mentioned device B for transporting the artificial blood vessel.In other words, the rear end portion of the tube 2 of the device B fortransporting the artificial blood vessel is drawn outside from the rearend of the balloon 23 b of the balloon catheter 23 while the front endportion of the tube 2 is passed through the balloon 23 b of the ballooncatheter 23 and exposed outside, with the portions of the catheter 23through which the tube 2 is passed being airtightly sealed. The rear endportion of the pipe 23 a is removably connected to the tube 2 of thedevice B for transporting the artificial blood vessel by a fixing member24, and the balloon catheter 23 and the tube 2 of the device B fortransporting the artificial blood vessel can be moved together as a unitlongitudinally when the fixing member 24 is fastened, and the ballooncatheter 23 can be moved longitudinally relative to the tube 2 of thedevice B when the fixing member 24 is loosened. The balloon catheter 23is so positioned that the front end thereof is spaced about 2 to 3 cmapart from the rear end of the artificial blood vessel A loosely fittedover the tube 2. Then the fixing member 24 on the balloon catheter 23 isfastened to fix the catheter 23 to the tube 2 so that the catheter 23and the tube 2 can be moved together as a unit.

Before or after the above step, the funneled tube 18 is attached to acartridge 6 as shown in FIG. 18. In attaching the funneled tube 18 tothe cartridge 6, the connector 18 b of the funneled tube 18 is insertedinto the annular member 62 of the cartridge 6 so that the check valve 68of elastic membrane provided inside the annular member 62 is pushed openby the connector 18 b of the funneled tube 18 as shown in FIG. 25, andthe connector 18 b is inserted a little deep into the straw 64 of thecartridge 6. Then the artificial blood vessel A is inserted into insideof the funneled tube 18 through the enlarged inlet opening 18 a withpicked by forceps as shown in FIG. 18. The front pull string 20 isinserted into the funneled tube 18 through the enlarged inlet opening 18a thereof and withdrawn forward through the straw 64 at the front end ofthe cartridge 6, with the tube 2 inserted a certain length into thefunneled tube 18. Under the condition, the front pull string 20 ispulled forward to introduce the artificial blood vessel A into thefunneled tube 18 through the enlarged inlet opening 18 a thereof.

Then the front end wire ring 10 ₁ of the artificial blood vessel A isdeformed to be flat as shown in FIGS. 19 and 20 with the positionspicked up by the forceps 19, namely the dividing points 41 ₁, 43 ₁approaching toward each other to be pushed into the funneled tube 18while the other dividing points 42 ₁, 44 ₁ restrained from the movementtoward the tubular connector 18 b by sliding contact with the taperedinner surface 18 d of the funneled tube 18. When the front end wire ring10 ₁ reaches adjacent the tubular connector 18 b of the funneled tube18, the front end wire ring 10 ₁ as a whole is folded into a regularwavy shape with the dividing points 41 ₁, 43 ₁ forming forwardlydirected peaks and other dividing points 42 ₁, 44 ₁ forming the bottomsof forwardly directed valleys. The intermediate wire rings 12 and therear end wire ring 10 ₂ also begin to transform into a wavy shape havingthe same phase as that of the front end wire ring 10 ₁, as shown in FIG.22, because both of them follow the movement of the front end wire ring10 ₁ toward the tubular connector 18 b with picked by forceps 19. Iffocused on the intermediate wire ring 12, as the intermediate wire ring12 is, as shown in FIGS. 23 and 24, fixedly attached to the tubularcover 7 only at the points 51 ₃, 52 ₃, 53 ₃, 54 ₃ of the circumferencethereof each of which corresponds to the midpoints between two adjacentdividing points, the point picked by the forceps 19 protrude forward andother points is left behind with the above-mentioned points 51 ₃, 52 ₃,53 ₃, 54 ₃ serving as fulcrum, thereby to cause the intermediate wirering 12 twisted and transformed into a wavy shape without dragging thetubular cover 7.

Under this condition, the forceps 19 are withdrawn from the funneledtube 18 and the front pull string 20 is pulled forward to fartherintroduce the artificial blood vessel A into the cartridge 6. As thefront pull string 20 is pulled forward, the pulling force applied to thefront end wire ring 10 ₁ is transmitted through the tubular cover 7 tothe intermediate wire rings 12 and the rear end wire ring 10 ₂, therebyto cause the intermediate wire rings 12 and the rear end wire ring 10 ₂to follow the movement of the front end wire ring 10 ₁. With theartificial blood vessel A perfectly contained in a cartridge 6 as shownin FIG. 25, the intermediate wire rings 12 and the rear end wire ring 10₂ are collapsed into a small size to take a wavy shape having the samephase as that of the front end wire ring 10 ₁ as shown in FIG. 26.

As the forceps 19 are provided with the above-mentioned serrate engagingmember 19 a, they can pick up and push the artificial blood vessel Ainto the funneled tube 18 for certain while they can be withdrawn fromthe funneled tube 18 with leaving the artificial blood vessel A in thefunneled tube 18 by slipping smoothly between the artificial bloodvessel A and the funneled tube 18. As the rings 10 ₁ and 10 ₂ arefolded, it is needless to say that the braid members 10 acircumferentially arranged about the front and rear end wire rings 10 ₁,10 ₂ are also folded to take a wavy shape with following the front andrear end wire rings 10 ₁, 10 ₂.

Under the condition, the front pull string 20 is untied or cut at anappropriate position thereof and pulled at its end so as to be withdrawnfrom the front hooking means 13, and the funneled tube 18 is withdrawnfrom the cartridge 6. Consequently, the artificial blood vessel A iscontained in the straw 64 of the cartridge 6, as shown in FIG. 27, andonly the balloon catheter 23 in which the tube 2 is provided is exposedoutside through the rear end portion 6 b of the cartridge 6 with thecheck valve 68 opened a little.

On the other hand, the catheter 8 has been previously inserted throughas shown in FIG. 28, for example, the coxal artery adjacent the groin Finto the blood vessel 9 as far as the front end of the catheter 8 hasbeen positioned a little beyond the affected portion 26 such as ananeurysm of the aorta as shown in FIG. 29. The attachment 5 connected tothe open end 8 a of the catheter 8 is, as shown in FIG. 28, exposedoutside the body. Next, the straw 64 of the cartridge 6 into which theartificial blood vessel A has been inserted is pushed into theattachment 5 through the rear end portion 5 a thereof until the bigportion 65 a makes abutting engagement with the rear end portion 5 awith the check valve 5 opened as shown in FIG. 28 and the cap 66 isadvanced to helically connect to the outer surface of the helical member52 a. Then the straw 64 of the cartridge 6 is positioned so that thefront end 6 a thereof is smoothly connected to the inner surface of theopen end 8 a of the catheter 8 and this condition is kept by the helicalconnection of the cap 66 and the helical member 52 a. Under thecondition, the balloon catheter 23 is gripped and the balloon catheter23 is pushed so as to be inserted gradually deeply into the catheter 8.As the tube 2 is, as shown in FIG. 17, connected to the balloon catheter23 through the fixing member 24 and the artificial blood vessel A isheld by the tube 2, movement of the balloon catheter 23 causes theartificial blood vessel A to be transported gradually to the deepposition in the body. The balloon catheter 23 is pushed until the frontend of the tube 2 is positioned at the front end of the catheter 8, asshown in FIG. 29. At this time the artificial blood vessel A ispositioned at the affected portion 26 as the target position. Then, asthe catheter 8 is withdrawn as shown in FIG. 30, with the ballooncatheter 23 and the tube 2 into which the wire 3 is inserted left at theobjective position, the collapsed artificial blood vessel A in thecatheter 8 is released at the affected portion 26 in the blood vessel 9while expanding gradually from the front end as shown in FIGS. 30, 31and 32. The released artificial blood vessel A is restored to itsoriginal tubular shape and urged against the inner wall of the bloodvessel 9. In other words, when the artificial blood vessel A collapsedinto small as shown in the figures is released from the catheter 23,each of the quadrisecting points elastically restores to a directiongenerally perpendicular to the blood vessel 9. Consequently, theartificial blood vessel A restores itself with each end portion thereofopen and the internal space of the artificial blood vessel A is notclosed by the internal wall of the blood vessel 9. Then the fixingmember 24 shown in FIG. 17 is loosened to disconnect the ballooncatheter 23 from the tube 2, and the balloon catheter 23 is advancedalong the tube 2 into the artificial blood vessel A with the tube 2 keptat the objective position as far as the front end of the ballooncatheter 23 reaches the front end of the artificial blood vessel A asshown in FIG. 33, whereupon the balloon 23 b is inflated by introducingair through the opening 23 c as shown in FIG. 33 thereby to restore theartificial blood vessel A completely to its original shape and securelyfix it onto the inner wall of the blood vessel. At this time the thorns12 a ₁ stick into the inner wall of the blood vessel 9 and are embeddedtherein. After the artificial blood vessel A has been thus fixed, theballoon 23 b of the balloon catheter 23 is deflated by drawing airthrough the opening 23 c and the balloon catheter 23 is pulled out fromthe artificial blood vessel A by pulling the pipe 23 a rearwardly. Thenit is confirmed that the artificial blood vessel A has been fixed ontothe inner wall of the blood vessel 9, and then the wire 3 is pulled outof the tube 2. As the front end of the wire 3 passes the rear edge ofthe side window 1 of the tube 2 as shown in FIG. 13, the loop portion 4a of the string 4 that has been caught by the wire 3 at the side window1 is released from the wire 3. Under the condition, when the tube 2 ispulled out, the string 4 slips out of the front hooking means 13 of theartificial blood vessel A. The balloon catheter 23 and the tube 2 arethen connected again by the fastener 24 and pulled out of the human bodywith only the artificial blood vessel A left at the desired position inthe blood vessel 9.

As mentioned above, in accordance with the invention, the artificialblood vessel A is implanted into the affected portion 26, and restoredto its original shape thereby to effectively prevent occlusion of theaffected portion 26 in the blood vessel 9. With the above-mentionedartificial blood vessel A and its collapsing method, the artificialblood vessel A can be collapsed with ease and accuracy. In other wards,as the intermediate wire ring 12 is collapsed into a wavy shape havingthe same phase as that of the front end wire ring 10 ₁, to put it in anextreme way each of the points 41 ₃˜44 ₃ on the circumferencecorresponding to the dividing points 41 ₁˜44 ₁ forms a peak of amountain or a bottom of a valley formed between two mountains by takingturns while the positions 51 ₃˜54 ₃ corresponding to midpoints 51 ₁˜54 ₁between each adjacent two of the dividing points move neither frontwardnor rearward at all. As the intermediate wire rings 12 are fixedlyattached to the tubular cover 7 at the points 51 ₃˜54 ₃, the portions ofthe intermediate wire ring 12 which bent most when being folded are freeof the tubular cover 7. This makes the intermediate wire ring 12 freefrom dragging resistance from the tubular cover, thereby to secure thefree movement to be collapsed with ease. In addition, as theintermediate wire ring 12 is collapsed into a wavy shape as well as thefront end wire ring 10 ₁, the whole artificial blood vessel A can befolded into a small size and even through a relatively bulky artificialblood vessel A can be effectively transported to the affected portion 26through a catheter 8. In addition, if the artificial blood vessel A isreleased at a target position in a blood vessel, the dividing points 41₁˜44 ₁ and the intermediate wire rings 12 are restored towardright-angled direction to the blood vessel together with the front endwire ring 10 ₁, and the artificial blood vessel A does not close theinner space thereof. This certainly improves a rate of successfulimplantation.

In this embodiment, as the flexible braid members 10 a arecircumferentially arranged on the front and rear end wire rings 10 ₁, 10₂ of the artificial blood vessel A, the inner wall of a human organ canbe prevented from being damaged by direct contact with the front andrear end wire rings 10 ₁, 10 ₂ in addition to the advantage that bothends of the implanted artificial blood vessel A can be sealed tightly tothe inner wall of a human body, thereby to effectively prevent leakageof blood through the ends of the artificial blood vessel A.

In this embodiment as the thorns 12 a ₁ project from the intermediatewire rings 12, they stick into the inner wall of a human organ to beembedded therein so that the whole artificial blood vessel A is fixed tothe human organ. Therefore, after the artificial blood vessel A has beenimplanted in the human organ, the thorns 12 a ₁ effectively preventdisplacement of the artificial blood vessel A, which may cause thevessel A to be carried by blood flow downstream in the blood vessel.

In this embodiment, as the number of the dividing points is set four, itis possible to make effective use of the forceps 19. In other words, asdescribed above, when whole of the artificial blood vessel A is pickedby forceps 19 along the generatrices l₅, l₆ which pass through twopoints 41 ₁, 43 ₁ of the front end wire ring 10 ₁ each of which hashooking means 13 and is arranged face to face and is inserted into thefunneled tube 18, the points picked by forceps 19 are carried ahead fromthe enlarged inlet opening 18 a to the tapered inner surface 18 d of thefunneled tube 18 and the dividing points 42 ₁, 44 ₁ each of which is notprovided with the hooking means 13 gradually approach each other withthe movement of following the dividing points 41 ₁, 43 ₁ restrained byabutting engagement with the tapered inner surface 18 d of the funneledtube 18 which prevents to follow. Consequently the artificial bloodvessel A is collapsed into a regular wavy shape with the points pickedup by forceps 19 forming forwardly directed peaks and the midpointsforming the bottoms of forwardly directed valleys. The same is true withthe intermediate wire rings 12 so that the intermediate wire rings 12easily transform into a wavy shape having peaks and valleys with thepoints 51 ₃, 52 ₃, 53 ₃, 54 ₃ on the circumference thereof correspondingto the midpoints between two adjacent dividing points of the front endwire ring 10 ₁ serving as fulcra, thereby to make the movement of beingcollapsed easy and accurate.

The serrate engaging member 19 a provided on the picking surface of theforceps 19 makes it very easy to insert or withdraw the forceps 19, asthe serrate engaging member 19 a facing against the direction to beinserted is useful to transform the urging force applied to the forceps19 into a propelling force to the artificial blood vessel A when theartificial blood vessel A is to be inserted, while the serrate engagingmember 19 a facing for the direction to be inserted makes it possible towithdraw the forceps 19 from the funneled tube 18 with the artificialblood vessel A in the funneled tube 18 left without dragging theartificial blood vessel A.

In addition, the device C for introducing the artificial blood vesselmakes it extremely easy and smooth to introduce the artificial bloodvessel A into the catheter 8. In other words, the reason why the deviceC is composed of the attachment 5 and the cartridge 6 each of which hasa check valve 55, 68 is not only to prevent blood from flowing backwardbut also to provide a strong portion with the device C to be handledeasily. Especially in this embodiment, the cap 66 is helically attachedto the outer surface of the helical member 52 a so as to joint thecartridge 6 and the attachment 5 liquid tightly. Consequently, excessivebleeding while the cartridge 6 is pulled out of the attachment 5 cancertainly be prevented as well as the front end of the straw member 64of the cartridge 6 can be kept to make a smooth connection with theinternal surface of the open end 8 a of the catheter 8. In addition, asthe above-mentioned cartridge 6 can be attached to the attachment 5 withaccuracy as long as the length of the straw member 64 projecting fromthe guide pipe 65 remains the same, the cartridge 6 can easily beapplied to the artificial blood vessel A in variety of length bychanging the length of the guide pipe 65 or of the straw member 64.

This invention is not limited to the above-mentioned embodiments. Forexample, if the vessel of the affected portion where the artificialblood vessel is to be implanted is different from the above mentionedand bifurcated, it is effective to use the artificial blood vessel Dshown in FIG. 34. The artificial blood vessel D is to be implanted, forexample, into the blood vessel of the groin. The artificial blood vesselD has fundamentally the same arrangement as that of the above-mentionedembodiment. This artificial blood vessel D, however, is for fitting theshape of the blood vessel into which the artificial blood vessel D isimplanted characterized by that a single front end wire ring 110 ₁ isarranged face to parallely arranged two rear end wire rings 110 ₂ eachof whose diameter is smaller than that of the front end wire rings 110₁, and a bifurcated tubular cover 107 connects the front end wire rings110 ₁ and two rear end wire rings 110 ₂. And intermediate wire rings 112₁ each of whose diameter is generally the same as that of the front endwire rings 110 ₁ are arranged at the position whose diameter is the sameas that of the front end wire ring 110 ₁, while intermediate wire rings112 ₂ each of whose diameter is generally the same as that the rear endwire ring 110 ₂ are arranged at the position whose diameter is the sameas that of the rear end wire ring 110 ₂. Each of the intermediate wirering 112 ₁, 112 ₂ is fixed to the cover 107 at a plurality of separatepositions on the circumference thereof as the same as in the formerembodiment.

On the other hand, the artificial blood vessel D which has beenpreviously collapsed into small is inserted into the catheter andtransported to a target organ. The method of collapsing the artificialblood vessel D will be described. A pair of strings 100 ₁, 100 ₂ areattached to each of the wire rings 110 ₁, 112 ₁, 112 ₂, 110 ₂ of theartificial blood vessel D at the points where each of the wire rings 110₁, 112 ₁, 112 ₂, 110 ₂ is fixed to the tubular cover 107. Theintermediate wire ring 112 ₁ is represented for concrete explanation.First, the string 100 ₁ is kept folded at the center thereof hooked by aneedle for operation. In this state the string 100 ₁ is wound around theintermediate wire ring 112 ₁ clockwise by making use of the needle untilit reaches the backward of the intermediate wire ring 112 ₁ as shown inFIG. 36, and then sewed up at a plurality of separate positions with theneedle. The positions at which the string 100 ₁ is sewed up fall on thegeneratrices corresponding to the midpoints between two adjacentdividing points of the front end wire ring 110 ₁, and in this embodimentthe string 100 ₁ is sewed up at two positions. The string 100 ₁ ispreferably sewed to the protective film (like the protective film 12 bin FIG. 2) which covers the surface of the intermediate wire ring 112 ₁,but may be sewed to the tubular cover 107 as long as the artificialblood vessel D is kept liquidtight. Likewise another string 100 ₂ iswound around the intermediate wire ring 112 ₁ counterclockwise and thensewed up at positions symmetric to the string 100 ₁. Next, insert a rod115 into the artificial blood vessel D for helping the artificial bloodvessel D be collapsed. Loop portions 100 a _(i), 100 a ₂ each formed ateach of the tip of a pair of strings 100 ₁, 100 ₂ are overlapped, intowhich a retaining rod 114 is inserted and then end portions 100 b ₁, 100b ₂ of the strings 100 ₁, 100 ₂ are tied together. The artificial bloodvessel D is helped to be collapsed by a finger or the like, ifnecessary. The intermediate wire ring 112 ₁ is gathered so that thepoints corresponding to the midpoints between two adjacent dividingpoints approach the rod 115 as a string is passed through each of thepoints, thereby to be collapsed into a wavy shape with the dividingpoints between the points at which the string is sewed up forming thebottoms of valley and the peaks in turn as shown in FIG. 37. Thisoperation is done to each of the wire rings 110 ₁, 112 ₁, 112 ₂, 110 ₂.The consequence is shown in FIG. 35. As it is clear in FIG. 35, thereare two retaining rods in this embodiment. The longer retaining rod 114₁ retains the area from the front end wire ring 110 ₁ to one of the rearend wire ring 110 ₂ to be collapsed, and the shorter retaining rod 114 ₂retains the area from the intermediate wire ring 112 ₂ located at thedivergence to the other rear end wire ring 110 ₂ to be collapsed.

The retaining rod 114 comprises a tube 114 a and a wire 114 b which isinserted into the tube 114 a. The tube 114 a is drawn out and only thewire 114 b is left after the artificial blood vessel D is kept in acollapsed condition. Although the wire 114 b is smaller in diameter thanthat of the tube 114 a, the wire 114 b can effectively bind the strings.In addition, the wire 114 b can be flexibly transformed into a bendingportion of the transporting course as softer than the tube 114 a. Inother words, the tube 114 a is temporarily used to make it easy to foldthe artificial blood vessel D and is drawn out together with the rod 115after the artificial blood vessel D is collapsed into a small size.

Thus folded artificial blood vessel D is transported to and implantedinto a target position, namely, a bifurcated affected portion by meansof the method in accordance with the embodiment. In this embodiment,three devices B₁, B₂, B₃ for transporting the artificial blood vesselare used as shown in FIG. 38. The first device B₁ for transporting theartificial blood vessel is the same as that used in the formerembodiment, namely, the one which is inserted into the tube 23 a of theballoon catheter 23 with the front tip passed through the artificialblood vessel D and projecting to reach the most front position and keepsa front end wire ring 110 ₁ with a string hooking a front hooking means113 of the front end wire ring 110 ₁. The second device B₂ fortransporting the artificial blood vessel is inserted into an elongatedhole formed on the thickness of the tube 23 a of the balloon catheter 23with the front tip thereof drawn outside in front of the balloon 23 band keeps a rear end wire ring 110 ₂ with a string 104 hooking a rearhooking means 113 a of the rear end wire ring 110 ₂. The third device B₃for transporting the artificial blood vessel is arranged parallel to theballoon catheter 23 and keeps another rear end wire ring 110 ₂ with astring 104 hooking a rear hooking means 113 a of the rear end wire ring110 ₂. The tube 102 of the device B₃ for transporting the artificialblood vessel is of especially softer material than that of other devicesfor transporting the artificial blood vessel. The tube 102 of the deviceB₃ for transporting the artificial blood vessel is provided with anelongated hole formed on the thickness thereof as well as the formerembodiment, into which the retaining rod 114 ₂ is inserted and passedthrough. Each of these devices B₁˜B₃ for transporting the artificialblood vessel is inserted into a body through the cartridge 6 and theattachment 5 of the former embodiment. As the devices B₁, B₂ areattached to the balloon catheter 23, they can pass liquidtightly throughthe cartridge 6 and the attachment 5 with the check valve 68 of thecartridge 6 and the check valve 55 of the attachment 5 pushed to open alittle. However, if the device B₃ is inserted into the check valves 68,55, opening is formed between the device B₃ and each of the check valves68, 55, thereby causing to decline liquidtightness. Then for using thedevice B₃, another hole (not shown in Figures) corresponding to thedevice B₃ should be provided at the position deviating from the centerof each check valves 68, 55.

Next, the process of implanting the artificial blood vessel D will nowbe described below. First, the device B₁ is pushed by making use of theballoon catheter 23 then like the former embodiment the balloon catheter23 is inserted into the catheter through the blood vessel of the groin.Next, the artificial blood vessel D is, as shown in FIG. 40, released atthe target position, in particular, the bifurcated affected portion. Theartificial blood vessel D is kept in a condition of being collapsed bythe retaining rod 114 ₁, 114 ₂. The artificial blood vessel D is locatedat a trunk of the blood vessel a little passing the affected portion byadjusting the position frontward of rearward with making use of thedevices B₁, B₂. Then the device B₃ is pushed into a body through thecatheter 8. As the device B₃ is made of soft material, it can be slackedoff toward a predetermined direction near the affected portion if aJ-shaped guide pipe F or the like is appropriately used as shown in FIG.41. Under the condition, a catcher E for catching the device fortransporting the artificial blood vessel is introduced near the affectedportion through the catheter from another bifurcated portion of thegroin. The catcher E comprises a tube e₁, a wire e₂ inserted into thetube e₁, and a U-shaped hook e₃ formed at the front tip of the wire e₂and which is projecting from the tube e₁, and is so constructed that thewire e₂ projects out of the tube e₁, the hook e₃ opens at the positionwhere the wire e₂ projects and that the hook e₃ closes by the tube e₁ atthe position where the wire e₂ is inserted into the tube e₁. The deviceB₃ which has previously slacked off is caught by making use of thecatcher E and then drawn out of the body through another portion of thebifurcated groin. After all of the devices B₁, B₂, B₃ are drawn out fromright and left portion of the groin as shown in FIG. 42, pulling forcetoward the direction shown by the arrow in the figure is applied to therear end wire rings 110 ₂ of the artificial blood vessel D by making useof the devices B₂ and B₃. Then each of the rear end wire rings 110 ₂ ofthe Y-shaped artificial blood vessel D is drawn from a trunk of theblood vessel into each of the bifurcated branches of the blood vessel.After the artificial blood vessel D is arranged along the bifurcatedblood vessels as shown in FIG. 43, the wire of the retaining rod 114 ₁,114 ₂ each attached to the device B₁, B₃ respectively for retaining theartificial blood vessel D in a collapsed condition is pulled out,thereby to release the artificial blood vessel D from being folded in asmall size. Then the artificial blood vessel D is restored as shown byimaginary lines in FIG. 43 and implanted into the internal wall of theaffected portion, namely, the bifurcated blood vessel. Finally, eachwire of the devices B₁, B₂, B₃ is pulled out, thereby to release thefront and rear hooking means from being kept, which makes it possible todraw the devices B₁, B₂, B₃ out of the body.

In accordance with the method of implanting the artificial blood vesselD, it is possible to implant an artificial blood vessel into an affectedportion with non-operational method even though the affected portionfalls on the bifurcated blood vessel. The artificial blood vessel D isnot always necessary to be folded into a small size beforehand by meansof strings 100 ₁, 100 ₂, it may sometimes be implanted through acatheter 8 just being collapsed into a small size as well as the simplecylinder-shaped artificial blood vessel A as shown in FIG. 1. The rearhooking means 113 a for pulling the rear end wire ring 110 ₂ and thesecond device B₂ for transporting the artificial blood vessel may beapplied to the rear end wire ring 10 ₂ of the artificial blood vessel Ashown in FIG. 1. This makes it possible to move the artificial bloodvessel A by adjusting the position of the artificial blood vessel Arearward or forward, after the artificial blood vessel A is releasedfrom the catheter 8 at the affected portion 26, thereby to implant theartificial blood vessel A with accuracy.

The artificial blood vessels may be restored in a cartridge by pullingout the retaining rod. It is effective that the artificial blood vesselspartially comprise a string of gold which can be X-rayed so as tomonitor the implanted condition of the artificial blood vessel.

The invention is not limited to the above-mentioned embodiments. Forexample, in the above embodiment, the front end wire ring has itscircumference divided into four equal arcs to set four dividing points.As shown in FIG. 44, a front end wire ring 210 ₁ may have itscircumference divided into eight arcs to set eight dividing points 241₁, 242 ₁, 243 ₁, 244 ₁, 245 ₁, 246 ₁, 247 ₁, 248 ₁, four of which 241 ₁,243 ₁, 245 ₁, 247 ₁ are provided with a hooking means and other four 242₁, 244 ₁, 246 ₁, 248 ₁ are not provided with a hooking means. As shownin FIG. 45, a front end wire ring 310 ₁ may have its circumferencedivided into six arcs to set sic dividing points 341 ₁, 342 ₁, 343 ₁,344 ₁, 345 ₁, 346 ₁, three of which 341 ₁, 343 ₁, 345 ₁ are providedwith a hooking means and other three 342 ₁, 344 ₁, 346 ₁ are notprovided with a hooking means.

In the above embodiment, the device for transporting the artificialblood vessel is provided with a pair of strings with loop portions. Thestrings need not always be provided in a pair. However, the stringsprovided in a pair are effective because a balanced pulling force can beapplied to the artificial blood vessel. The loop portions may be twistedas a whole. A device for transporting the artificial blood vesselcomprising only a tube and a wire and which is not provided with stringsmay be used. For example, as shown in FIG. 46, front hooking means 413formed on the front end wire ring 410 ₁ are made a little longer, eachof loop portions of the front hooking means 413 are overlapped, and awire 403 pulled out of a side window 401 of a tube 402 is passed thoughand inserted into the overlapped loop portion so as to keep theartificial blood vessel. If there is no trouble to form holes directlyon the tubular cover, it is also possible to keep the artificial bloodvessel by means of a wire and a tube with making use of the holes as ahooking means.

Therefore, such a device for transporting the artificial blood vesselcan be used to a patch to close a hole formed on a heart or the like.

The intermediate wire rings 112 may be bridged by a supporting rod 500as shown in FIG. 34. The supporting rod 500 attached to the intermediatewire rings 112 improves the tubular shape of the artificial blood vesselD in the strength and the construction. The supporting rod 500 may beattached to the front or rear end wire ring 110 ₁, 110 ₂. If thesupporting rod 500 is fixed to the same position on the circumference ofthe front or rear end wire ring 110 ₁, 110 ₂ as that of the intermediatewire ring 112, it does not prevent the artificial blood vessel D frombeing folded.

In order to collapse the artificial blood vessel A into a small size byinserting it into a funneled tube 18 from a big portion 18 a toward asmall portion 18 b the artificial blood vessel A may be previouslycontained in a pipe member 600 having a diameter bigger than that of thesmall portion 18 b of the funneled tube 18 and smaller than that of thebig portion 18 a of the funneled tube 18 as shown in FIG. 47. Justinserting the pipe member 600 into the funneled tube 18 so as to makeabutting engagement with the inner surface of the funneled tube 18 andpulling out the artificial blood vessel A from the side of the front endwire ring enables the artificial blood vessel A to be collapsed into asmaller size so as to be inserted into the small portion 18 b of thefunneled tube 18 and a catheter.

In addition, as shown in FIG. 48, two the artificial blood vessel A₁, A₂may be prepared and the front end wire ring 10 ₁ of the artificial bloodvessel A₂ which is to be inserted later locates in front of the rear endwire ring 10 ₂ of the artificial blood vessel A₂ which is to be insertedformer so that the artificial blood vessel A₁ is connected to theartificial blood vessel A₂ with each other partially overlapped at theadjacent position. Then the whole length of the connected the artificialblood vessel can be changed relatively freely by adjusting the length ofthe overlapped portion. This makes it possible that the artificial bloodvessel A₁, A₂ having the same standard can be tailored for the affectedportion 28 whose length or shape varies a little. It is especiallypreferable that the artificial blood vessel A₂ arranged downstream has adiameter which is smaller than that of the artificial blood vessel A₁arranged upstream and that the artificial blood vessel A₂ arrangeddownstream is partially inserted into the artificial blood vessel A₁arranged upstream. Thus arranged the artificial blood vessel A₁, A₂ areconnected smoothly as well as they can be implanted satisfactory so asto fit the shape of the blood vessel into which the artificial bloodvessels A₁, A₂ are to be implanted because usually blood vessels aregradually smaller in diameter from upstream to downstream. Of course,even if artificial blood vessels have the same diameter, it is notdifficult to partially insert one of the artificial blood vessels intoanother just by transforming one of the artificial blood vessels.

Next, when an artificial blood vessel is to be implanted into anaffected portion whose shape is bifurcated as described above, a morepreferable mode of embodying the invention will now be described indetail with reference to FIGS. 49 through 53.

The artificial blood vessel D shown in FIG. 49 is fundamentally the samein arrangement as that of FIG. 34. Unlike the artificial blood vessel Dwhich is inserted into a catheter 8 with the whole artificial bloodvessel D folded into a small size as shown in FIG. 35, in thisembodiment the artificial blood vessel D is inserted into a catheter 8with only a bifurcated portion of small diameter folded into a smallsize as shown in FIG. 49. The reason is to prevent the thorn body 12 a ₁from unnecessarily hurt the tissues of the body to be implanted. This isdone by releasing at least a main portion of the artificial blood vesselD at a predetermined position from the first so as to avoid adjustingthe position of the main body after released. The artificial bloodvessel D is folded into a small size by means of the strings 100 ₁, 110₂ and the retaining rod 114 like the embodiment explained with referenceto FIGS. 36 and 37. Then as shown in FIG. 49, the artificial bloodvessel D is transported to a bifurcated affected portion as a targetposition by means of the above-mentioned three devices B₁, B₂ and B₃ fortransporting the artificial blood vessel (see FIG. 38). Unlike theabove-mentioned embodiment, no balloon catheter is attached to the firstdevice B₁ for transporting the artificial blood vessel in thisembodiment, however, it is a matter of course that a balloon cathetermay be attached if necessary. In this case, the balloon catheter is notnecessarily inserted into a body together with the artificial bloodvessel D, but can be inserted into a body after the artificial bloodvessel D is transported to a target organ in the body.

As shown in FIG. 49, the first device B₁ for transporting the artificialblood vessel holds the front end wire ring 110 ₁ with the front endthereof passing through the artificial blood vessel D and protrudingtoward the forefront. The second device B₂ for transporting theartificial blood vessel holds one of the rear end wire rings 110 ₂ withthe front end thereof locating rear of the artificial blood vessel D.The third device B₃ for transporting the artificial blood vessel holdsthe other rear end wire ring 110 ₂ with the front end thereof locatingrear of the artificial blood vessel D. Like the embodiment shown in FIG.38, retaining rods 114 ₁ and 114 ₂ for keeping the artificial bloodvessel D in a collapsed condition are attached, although not shown inFIG. 49, to the second and the third devices B₂ and B₃ for transportingthe artificial blood vessel. Especially the third device B₃ fortransporting the artificial blood vessel used in this embodiment is madeof a material more flexible than that the other devices B₁ and B₂ aremade of. In addition, at least the length corresponding to a distancefrom a groin of a thigh to the affected portion of the base end B_(3a)of the third device B₃ for transporting the artificial blood vessel ismade of a guide member b_(3x) such as a helical spring which is not onlyflexible but also having a characteristic that a force can be sotransmitted to the whole part thereof by manipulating one part thereofthat the whole device B₃ can be freely rotated, inserted or pulled. Thebase end b_(3a) is bent sideward along the length thereof, which makesit possible to change the position of the base end b_(3a) relatively bigby manipulating the guide member b_(3x) of the device B₃.

These devices B₁, B₂ and B₃ are inserted into a catheter 8 through thecartridge 6 and the attachment 5 shown in FIG. 28. As mentioned above,since the devices B₁ and B₂ are not attached to a balloon catheter, thedevices B₁ and B₂ are bundled together with the device B₃ and insertedinto the cartridge 6 with the valve 68 pushed to open. As a result ofthis, when the cartridge 6 is attached to the attachment as shown inFIG. 28, bleeding is likely to occur from the portion through which thedevices B₁, B₂ and B₃ are inserted. Then in this embodiment a sheath 700to prevent leakage is provided beforehand as shown in FIG. 49 at therear end of the cartridge 6. After the devices B₁, B₂ and B₃ areinserted into the cartridge 6 together with the artificial blood vesselA, the sheath 700 is connected to the cartridge 6 with the valve 68pushed to open. In FIG. 50 the cartridge 6 and the attachment 5 providedbetween the sheath 700 and the catheter 8 are omitted. The sheath 700has fundamentally the same arrangement as that of the catheter 8 and isprovided with a valve 701 at the rear end thereof. At the center of thevalve 701 provided is a hole 711 which can be pushed to open against theelasticity of the valve 701 as shown in FIG. 51. The valve 701 is alsoprovided with other three holes 712 each of which locates radially andequally distant from the center of the valve 701 and the distancebetween each adjacent hole 712 is the same. Between the hole 711 andeach of the holes 712 provided is thick embankment 713 so as not to beeasily connected through both of the holes 711 and 712 each otherbecause of breakage. In this embodiment the first device B₁ is insertedinto and passed through the hole 711 and each of the second and thirddevices B₂ and B₃ is inserted into and passed through two of the threeholes 712 respectively. Instead of the valve 701, a valve 702 as shownin FIG. 52 may be used. The valve 702 has holes 721 and 722 at thepositions corresponding to the holes 711 and 712 of FIG. 51. On thecircumference of each hole 721 and 722 provided are annular projectingportions 721 a and 722 a whose inside is dent to make thin. Thusarranged valve is effective for preventing breakage between the hole 721and the holes 722. The device B₃ is inserted into and passed through thecatheter 8 through a guide pipe H as shown in FIG. 49. The guide pipe His so arranged that the base end h₁ locates out of the sheath 700 andthe front end h₂ passes through the sheath 700 and a catheter 8 and thenlocates near a bifurcated affected portion. At the base end h₁ of theguide pipe H provided is a valve 70 as shown in FIG. 53. The valve 70 isprovided with two holes 70 a and 70 b which can be pushed to openagainst elasticity of the valve 70 and into which the front end of thedevice B₃ is inserted.

Next, the process of implanting the artificial blood vessel D will bedescribed below. Like the process shown in FIG. 25, first, the firstdevice B₁, the second device B₂ and the guide pipe H are inserted intothe cartridge 6 together with the collapsed artificial blood vessel D bypushing to open the hole of the valve 68. The third device B₃ isinserted into the guide pipe H through the hole 70 a of the valve 70provided at the base end h₁ of the guide pipe H. Next, the sheath 700 isinserted into the cartridge 6 by pushing to open the valve 68 providedat the rear end of the cartridge 6. Since the devices B₁, B₂ and B₃ areinserted into and passed though the holes 711 and 712 of the sheath 700beforehand as mentioned above, (the third device B3 is inserted into theguide pipe H) when the front end of the sheath 700 is inserted into thecartridge 6 through the valve 68, inside the cartridge 6 is connectedthrough inside the sheath 700 and the inner space is liquidtightlysealed from outside of the valve 701. After the artificial blood vesselD is transported to a predetermined position beyond groin of thebifurcated affected portion by manipulating the first device B₁, theartificial blood vessel D is released from the catheter 8 as shown inFIG. 49. Accompanying to the artificial blood vessel D, the second andthird devices B₂ and B₃ are dragged and introduced into the body. Thethird device B₃ is introduced into the body accompanying to the guidepipe H. The artificial blood vessel D is released after the main portionof the artificial blood vessel D is arranged at the predeterminedposition. The bifurcated portion of the artificial blood vessel D iskept in a collapsed condition by the retaining rod 114 ₁ and 114 ₂ shownin FIG. 38 after released. In this step, another bifurcated rear endwire ring 110 ₂ is pushed to the bifurcated portion as shown by thearrow Z in FIG. 49 by means of the third device B₃. Next, in thisembodiment the base end b_(3a) of the third device B₃ is turned down andinserted into the guide pipe H. More specifically, the base end b_(3a)of the third device B₃ is pushed to open the hole 70 b of the valve 70shown in FIG. 53 so as to be inserted into the guide pipe H. After this,the guide member b_(3x) is gripped so as to push and transport the thirddevice B₃ until the base end b_(3a) is introduced into the body throughthe front end h₂ of the guide pipe H. Under the-condition, a catcher Gfor catching the device for transporting the artificial blood vessel isintroduced into near the affected portion through the catheter K fromanother bifurcated portion of the groin. The catcher G is made of a tubeg₁ into which two wire members g₂ and g₃ are inserted and passed throughwith both of the front ends of the wire members g₂ and g₃ connected toform a loop. Concretely the catcher G is so arranged that a single wiremember is inserted into and passed though the tube g₁ and then the frontend of the single wire member is turned down and again inserted into thetube g₁ through the same end of the tube g₁ from which the single wiremember is out. Then when the wire members g₂ and g₃ are pushed againstthe tube g₁, the loop projecting out of the tube g₁ becomes bigger andwhen the wire members g₂ and g₃ are pulled from the tube g₁, the loopprojecting out of the tube g₁ becomes smaller. Next, the base end b_(3a)is caught by the catcher G by manipulating the guide member b_(3x) ofthe third device B₃ and the catcher G. As mentioned above, the thirddevice B₃ is curved around the base end b_(3a) so as to make it easy forthe catcher G to catch the device B₃. As a result of this, it becomeseasy to rotate, insert or pull the third device B₃ by handling the guidemember b_(3x) which is out of the guide pipe H. After being caught bythe catcher G, the base end b_(3a) is pulled out of the body throughanother groin of the thigh. As the base end b_(3a) is pulled further,the length of the third device B₃ being out of the valve 70 of the guidepipe H becomes shorter and shorter and finally the third device B₃strains itself between the hole 70 a and the hole 70 b of the valve 70.Then the valve 70 between the hole 70 a and the hole 70 b isartificially broken so that the third device B₃ is fully contained inthe guide pipe H. The valve 70 may be broken by a surgical knife, or astick shaped material. If the stick shaped material is left in the guidepipe H after the valve 70 is broken, it can effectively prevent bleedingfrom the broken part of the valve 70. Next the base end b_(3a) of thethird device B₃ is further pulled out of the body through another groinof the thigh until only the front end of the third device B₃ is left inthe body as shown in FIG. 50. After the third device B₃ is pulled out ofthe body, the rear end wire ring 110 ₂ of the Y-shaped artificial bloodvessel D is introduced into an appropriate position of another branchfrom the trunk of the blood vessel by being pulled toward the directionshown by the arrow of FIG. 50. After the artificial blood vessel D isarranged in the appropriate position, the wires of the retaining rods114 ₁ and 114 ₂ (shown in FIG. 42) each of which is attached to thesecond and the third devices B₂ and B₃ respectively are pulled so as torelease the artificial blood vessel D from a collapsed condition. Thenthe bifurcated portions of the artificial blood vessel D are restored tothe original shape and implanted into the bifurcated internal wall ofthe blood vessel in the affected portion. Finally, each wire 3 of thedevices B₁, B₂ and B₃ (see FIG. 15) is drawn so as to be released fromthe front end wire ring 110 ₁ and the rear end wire ring 110 ₂. Then thedevices B₁, B₂ and B₃ can be taken out of the body.

In accordance with the above-mentioned method, the third device B₃ canbe caught by the catcher G with accuracy without entangling in theartificial blood vessel D. More specifically, since the third device B₃is inserted into the catheter 8 through the guide pipe H in thisembodiment, the third device B₃ can be isolated from the artificialblood vessel D or the like while being transported in the catheter 8,thereby to avoid without fail inconvenience of the third device B₃entangling in the artificial blood vessel D or the devices B₁ and B₂which may otherwise occur when the third device B₃ is directly insertedinto the catheter 8 without using the guide pipe H. This also avoidsinconvenience of dragging the artificial blood vessel D or the devicesB₁ and B₂. As a result of this, the third device B₃ can be introducedinto another branch without fail. Since the guide pipe H is arrangedwith its front tip h₂ closer to the bifurcated position of the affectedportion than the front end of the catheter 8, it becomes easier to catchthe base end b_(3a) by the catcher G. As a result of this, the rate ofsuccessful implanting can drastically be improved. This effect can alsobe obtained by using the J-shaped guide pipe F shown in FIG. 41.However, in this embodiment since not only the front end of the deviceB₃ but also the base end b_(3a) thereof is turned down, the base endb_(3a) can be caught by the catcher G when the base end b_(3a) projectsout of the front end h₂ of the guide pipe H. Consequently, the positionof the base end b_(3a) can freely be adjusted by manipulating the guidemember b_(3x). As a-result of this, the device B₃ can be caught withhigher accuracy by the catcher G. In addition, since the front end ofthe catcher G is loop-shaped and smooth, there is no danger of damagingtissues of the body. Further, since the third device B₃ is transportedin the catheter K in a condition of being folded into a V-shape when itis to be taken after caught, the base end b_(3a) of the third device B₃can be taken out of the body without fail.

The device B (B₁, B₂ and B₃) for transporting the artificial bloodvessel can be modified in each of the above-mentioned embodiments. Theside window formed in the tube 2, shown in FIGS. 54 through 58,comprises the first and the second opening holes 11H and 12H each spacedapart. The wire 3 pulled out of the tube 2 though the first opening hole11H is hooked by the strings 4 and then introduced into the tube 2through the second opening hole 12H. Thus arranged device B fortransporting the artificial blood vessel does not require a big openinglike the side window shown in FIG. 5. As a result of this, the tube 2around the side window is thick enough to prevent bending, therebyeffectively improving strength of the device B. In this case the crosssection of the device B may have a flat portion 2X between the openingholes 11H and 12H as shown in FIGS. 59 though 63. With the device Bhaving the flat portion 2X, the wire 3 pulled out of the first openinghole 11H can be inserted into the second opening hole 12H with the wire3 remaining relatively straight. Then the wire 3 can effectively beprevented from bending and it also avoids a case that the wire 3 failsto be pulled out of the tube 2. FIG. 64 shows another cross sectionhaving a concaved portion 2Y. As a further different modification shownin FIGS. 65 though 67, the tube 2 may comprise two tube elements 2A and2B each spaced apart, and a connector 2C for connecting the outercircumferences of both tube elements 2A and 2B. As shown in FIGS. 65-70,connector element 2C is shaped in the form of a rod. No matter whatarrangement the tube has, as far as the tube is strong enough as awhole, the device for transporting the artificial blood vessel cantransport artificial blood vessels appropriately. The tube comprisingtwo tube elements is especially effective for a tube having an extremelysmall diameter. If the tube of an extremely small diameter is providedwith a side window, the window occupies most of the tube, which mayweaken the strength of the tube. Consequently, the tube comprising twotube elements 2A and 2B can keep an appropriate strength as far as thematerial used for 2C is strong enough. The connector 2C may connect theinternal circumferences of two tube elements 2A and 2B as shown in FIGS.68 though 70. The cross section of the tube element 2A, 2B is notlimited to a circle as shown in FIG. 69, but may be flat or flat withpartial circle. In addition, the device B for transporting theartificial blood vessel shown in FIGS. 54 through 70 may not have astring 4. In this case, the device B can pull the artificial bloodvessel A effectively if the wire 3 is directly inserted into hookingmeans or a hole directly formed on the cover.

On the other hand, as a modification of the artificial blood vessel, itis effective to use the artificial blood vessel shown in FIG. 71. Theartificial blood vessel P has basically the same arrangement as that ofthe artificial blood vessel A shown in FIG. 1 except that an elasticthread 500 (for example, thread of urethane or the like) which canexpand or contract so as to shrink a length of the artificial bloodvessel P is embedded inside the tubular cover 7 along a specifiedgeneratrix. Thus arranged artificial blood vessel P can be transportedin the catheter 8 in compact when folded into a small size like theabove mentioned embodiment. In addition, since the artificial bloodvessel P is restored into a curved shape as shown in FIG. 71 whenreleased from the catheter 8 because the elastic thread 500 restrains apart of the artificial blood vessel P from restoring into a cylindricalshape, the artificial blood vessel P sticks to the blood vessel tightlywhen implanted into a curved affected portion such as a bowed portion ofaorta, thereby to prevent leakage. This effect can greatly be improvedif the artificial blood vessel P is used with an artificial blood vesselhaving a bellow portion.

It is also effective if a part or whole of the catheter 8 is made ofbellow, although not shown in figures. A catheter 8 of a simplecylindrical shape is not only easy to break but also difficult torestore if once broken, which may lead to stricture in a body. While thecatheter 8 made of bellow fits to a bent portion of the body easily withforming a natural curve, thereby to effectively avoid stricture in abody. Thus bellow-shaped catheter is suitable for transporting variouskinds of appliances in addition to artificial blood vessels.

The device B for transporting the artificial blood vessel used in theabove embodiments can be applied to pull various kinds of appliances inaddition to artificial blood vessels so as to introduce them into abody. The guide pipe H having valve 70 is also suitable for arranging anartificial blood vessel into a bifurcated portion having two or morebranches. For example, when an artificial blood vessel having branchesbifurcated from a trunk is used for the aorta of a neck, the trunk isarranged on the bowed portion of the aorta and the branch is introducedinto the carotid artery or the upper arm artery. In this case theartificial blood vessel can be implanted with ease and accuracy by usingthe guide pipe H. Further the valve 68 shown in FIGS. 51 and 52 can beapplied when a plurality of devices for transporting the artificialblood vessel are parallely introduced into a body without causingbleeding.

POSSIBLE APPLICATIONS IN INDUSTRY

As mentioned above, the appliance to be implanted in accordance with theinvention is valuable as an artificial blood vessel. It also can becollapsed into a small size to take a regular wavy shape having the samephase as a whole by means of the method of collapsing the appliance tobe implanted in accordance with the invention especially because ofsmooth movement of the intermediate wire rings. The method of using theappliance to be implanted in accordance with the invention makes itpossible to implant a Y-shaped appliance to be implanted into abifurcated portion of a human organ easily with non-operational method.

What is claimed is:
 1. A device for transporting an appliance to beimplanted, comprising a tube having a front end, formed with a sidewindow adjacent said front end, said tube being insertable into theappliance to be implanted, and a wire inserted into the tube through thefront end of the tube so as to extend along the side window of the tube,the wire extending out of said side window over which the appliance tobe implanted is engageable, said wire extending again into the tubethrough the side window so as to engage and hold the appliance to beimplanted between the wire and the tube; characterized by that the sidewindow formed in said tube comprises first and second opening holesspaced apart from each other and through which said wire exits andenters the tube, respectively.
 2. A device for transporting an applianceto be implanted, described in claim 1 wherein the tube has a portionthat in cross section is flat or concaved between the first and thesecond opening holes.
 3. A device for transporting an appliance to beimplanted, comprising a tube having a front end, formed with a sidewindow adjacent front end, said tube being insertable into the applianceto be implanted, and a wire inserted into the tube through the front endof the tube so as to extend along the side window of the tube, the wireextending out of said side window over which the appliance to beimplanted is engageable, said wire extending again into the tube throughthe side window so as to engage and hold the appliance to be implantedbetween the wire and the tube; characterized by that said tube comprisestwo tube elements spaced apart from each other and a connector forconnecting the tube elements, said side window being formed between saidtube elements.
 4. A device for transporting an appliance to beimplanted, described in claim 3 wherein said connector is shaped in rodform.